Open AccessMassive infected ascites in an immunocompetent patient with gastrointestinal tuberculosis
Author(s) -
Carmegie C Saliba,
Isabelle Dominique Tomacruz,
Mary Louise Margaret M Javier,
Homer Co
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-230794
Subject(s) - medicine , ascites , spontaneous bacterial peritonitis , paracentesis , peritonitis , tuberculosis , mycobacterium tuberculosis , regimen , surgery , antibiotics , gastroenterology , pathology , microbiology and biotechnology , biology
Mycobacterium tuberculosis is highly endemic in the Philippines. The diagnosis is challenging with its non-specific presentation and the organism could extend to any of the organs. Interestingly, bacterial peritonitis arising spontaneously from gastrointestinal tuberculosis (TB) in an otherwise healthy, non-cirrhotic patient is quite unusual. In this paper, we discuss the case of a 27-year-old HIV-seronegative woman with massive intraperitoneal mixed bacterial and tuberculous abscess presenting 20 months after being diagnosed with bacteriologically confirmed gastrointestinal TB. Repeated large-volume paracentesis was done to drain out the infected ascites instead of inserting a percutaneously implanted catheter. Clinical improvement was noted and she was discharged after 12 days of intravenous antibiotics. She had completed 6 months of antituberculosis therapy and been well since then. The case has demonstrated that repeated paracentesis along with appropriate antibiotic regimen, may be a viable option for patients with TB and bacterial coinfected peritonitis. And possibly, peritoneal TB may increase the risk for (spontaneous) bacterial peritonitis.